Workers Compensation Claims Examiner | NY Jurisdiction

Sedgwick • Syracuse, NY

1d • Hybrid

About The Position

The Workers Compensation Claims Examiner analyzes lost-time workers’ compensation claims for clients to determine benefits due and ensure claims are adjudicated within service expectations, industry best practices, and client requirements. The role investigates claims, gathers information to determine exposure, develops action plans, negotiates settlements within designated authority, communicates claim activity to claimants and clients, and reports claims to excess carriers while responding promptly and professionally to requests for direction.

The position is hybrid for candidates within commuting distance of the Syracuse, New York office and remote for candidates outside that distance. Sedgwick describes the role as offering a flexible work schedule, career development and promotional growth opportunities, and a comprehensive benefits package. The stated starting pay range for the jurisdiction in the posting is $70,000–$80,000.

Requirements

• At least two years of claims management experience, or an equivalent combination of education and experience.
• High school diploma or GED.
• Ability to think clearly and conceptually, exercise excellent judgment and discretion, troubleshoot, solve problems, and perform analysis.
• Ability to handle work-related stress, manage multiple priorities simultaneously, and meet deadlines.
• Computer keyboarding ability.
• Hearing, vision, and talking abilities.

Nice To Haves

• Bachelor’s degree from an accredited college or university.
• Professional certification applicable to the line of business.
• New York licensing is preferred but not required.

Responsibilities

• Analyze and process claims using developed action plans to reach appropriate and timely resolutions.
• Investigate claims and gather information to determine claim exposure.
• Negotiate claim settlements within designated authority.
• Communicate claim activity and processing with claimants and clients.
• Report claims to the excess carrier and respond to requests for direction professionally and promptly.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• Medical insurance.
• Dental insurance.
• Vision insurance.
• 401(k) plan and matching.
• Paid time off (PTO).
• Disability insurance.
• Life insurance.
• Employee assistance program.
• Flexible spending account or health savings account.
• Additional voluntary benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED